ABSTRACT
Objective:To investigate the effect of diabetes on the occurrence of early adverse reactions of intensity-modulated radiotherapy in patients after radical mastectomy for breast cancer.Methods:The clinical data of 102 breast cancer patients who underwent intensity-modulated radiotherapy after radical mastectomy for breast cancer in Nanjing Drum Tower Hospital Group Suqian Hospital from October 2014 to December 2020 were retrospectively analyzed, including 32 cases in the diabetes group and 70 cases in the non-diabetes group. The incidence of early adverse reactions of intensity-modulated radiotherapy in the two groups was compared, the effects of blood glucose before radiotherapy on the early adverse reactions of intensity-modulated radiotherapy and the lymphocyte count before and after intensity-modulated radiotherapy were analyzed.Results:There were 9 cases (28.1%) and 1 case (3.1%) of grade 1 and 2 acute radiation pneumonitis in the diabetes group, and 6 cases (8.6%) and 1 case (1.4%) in the non-diabetes group, respectively, and there was a statistical difference between the two groups ( χ2 = 7.22, P = 0.027). Grade 1-3 acute radiation dermatitis occurred in 16 cases (50.0%), 13 cases (43.8%) and 3 cases (6.2%) in the diabetes group, and 53 cases (75.7%), 15 cases (21.4%) and 2 cases (2.9%) in the non-diabetes group, respectively, and the difference between the two groups was statistically significant ( χ2 = 6.99, P = 0.030). According to the level of fructosamine before radiotherapy, the patients with diabetes were divided into normal blood glucose control group (fructosamine ≤2.5 mmol/L) and poor blood glucose control group (fructosamine >2.5 mmol/L), and there was statistical difference in the morbidity of acute radiation dermatitis between the two groups ( P = 0.039). Before radiotherapy, there was no significant difference in lymphocyte count between the normal and poor blood glucose control groups ( P > 0.05). After radiotherapy, the lymphocyte count in both groups was significantly lower than that before radiotherapy, and the decrease was more obvious in the poor blood glucose control group, the difference was statistically significant ( P = 0.021). Conclusions:The postoperative patients with breast cancer complicated with diabetes have a high incidence of acute radiation pneumonia and acute radiation dermatitis. Patients with poor blood glucose control are more likely to have acute radiation dermatitis.
ABSTRACT
Objective: To investigate the feasibility of differential diagnosis of invasive lung adenocarcinoma and non-calcified lung tuberculoma on CT plain images based on texture analysis. Methods: Data of plain CT images of 52 patients with single pulmonary nodules confirmed pathologically were retrospectively analyzed, including 31 cases of invasive lung adenocarcinoma and 21 cases of non-calcified lung tuberculosis. Totally 300 texture features of each kind of lesions were extracted with MaZda software, then 10 optimized texture parameters were selected for texture analysis with fisher coefficient (Fisher), minimization of both probability of classification error and average correction coefficient (POE+ACC), mutual information coefficients (MI) methods, respectively, and the optimal texture features combination combined with three methods (MPF) was obtained. The four groups of optimal texture characteristics were classified using linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA), while classification of LDA and NDA were performed using K-nearest neighbor classifier (K-NN) and artificial neural network (ANN), respectively. The minimum error probability of 4 groups of texture features in differential diagnosing of 2 kinds of lesions was analyzed, the differences of 30 optimal texture features were compared between 2 kinds of lesions, their ROC curves for identifying 2 kinds of lesions were drawn, and then AUC of the curves were calculated to evaluate their diagnostic performance. Results: For single group of optimal texture features, NDA/ANN-Fisher method had the lowest error rate (7.69% [4/52]), while for MPF, the error rate of NDA/ANN-MPF was the lowest (5.77% [3/52]). There was no statistical difference of error rate between NDA/ ANN-Fisher and NDA/ ANN-MPF method (χ2=0.15, P>0.05). Statistical differences of 10 optimal texture features were noticed between 2 kinds of lesions, among which difference entropy S(1,1), difference variance S(1,1) and gradient variance had good diagnostic efficacy (AUC=0.71, 0.71, 0.70), and their AUC were not statistically different (all P>0.05). Conclusion: Based on texture analysis of plain CT images, invasive lung adenocarcinoma and non-calcified lung tuberculosis can be well distinguished, providing objective and reliable basis for differential diagnosis of these two lesions.